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USPSTF: Focus on Older Adults


The U.S. Preventive Services Task Force (USPSTF) is committed to improving the health of America's older adults. To achieve this, the USPSTF makes evidence-based recommendations for older adults and convenes a workgroup dedicated to developing new approaches to assessing evidence on the health of older adults.


Contents

What is the U.S. Preventive Services Task Force?
What is the USPSTF Older Adults Workgroup and What Does It Do?
How Does the USPSTF Review Evidence on the Health of Older Adults?
Current Research to Improve the Health of Older Adults
USPSTF Recommendations for Older Adults
Opportunities to Comment on USPSTF Draft Recommendations for Older Adults
Tools for Using the USPSTF Recommendations for Older Adults

What is the U.S. Preventive Services Task Force?

The USPSTF is an independent panel of experts in prevention and primary care that evaluates available evidence and makes recommendations about clinical preventive services, including screenings, counseling, and preventive medications. The Task Force determines whether or not the evidence supports providing a clinical preventive service in primary care settings to people without symptoms. For a service to be recommended, the evidence must show that the potential benefits of providing that service outweigh the potential harms.

Select to learn more about the USPSTF.

Select to learn more about how the USPSTF reviews and rates evidence.

Some recommendations made by the USPSTF apply to people in specific age groups. Therefore, the USPSTF includes members with expertise related to different stages of life. USPSTF membership includes geriatricians, family physicians, and nurse practitioners who specialize in the care of older adults. In addition, the USPSTF seeks advice from Federal agencies and major professional societies focused on the health of older adults, including the Veterans Health Administration, the Administration on Aging, the American Academy of Family Physicians, the American Medical Association, and AARP. The USPSTF also convenes an Older Adults Workgroup to address the specific preventive health needs of this population.

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What is the USPSTF Older Adults Workgroup and What Does It Do?

The Older Adults Workgroup of the USPSTF is a group of USPSTF members and other experts with interest and expertise in special issues facing older adults. The goal of the Older Adults Workgroup is to provide feedback to the larger Task Force on methods of reviewing evidence and developing evidence-based recommendations on preventive services specific to older adults.

Activities of the Older Adults Workgroup include:

Select for a list of current USPSTF Older Adults Workgroup members.

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How Does the USPSTF Review Evidence on the Health of Older Adults?

Developing evidence-based recommendations on preventive services for older adults is challenging because: 1) many diseases in older adults have multiple different risk factors and causes; 2) individual preventive interventions for older adults address multiple diseases and outcomes; 3) older adults are not often included in medical studies; and 4) important outcomes may not be studied or reported in ways conducive to evidence synthesis and interpretation. To address these challenges, the USPSTF has committed to identifying ways to focus on older adults in all stages of its work, from topic selection and prioritization to post-publication dissemination. The USPSTF Older Adults Workgroup has developed a draft analytic framework to use when reviewing the evidence on the benefits of preventive services for older adults; the analytic framework will be further refined in future work.

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Current Research to Improve the Health of Older Adults

Review on common syndromes in older adults related to prevention (PDF File, 4.9 MB; PDF Help). This review addresses 1) the definition and prevalence of common syndromes in older adults in the United States; 2) the prevalence of common syndromes in specific population subgroups; 3) the association among common syndromes and morbidity, mortality, quality of life, independent living, hospitalization, and activities of daily living; and 4) available tools that help understand morbidity or mortality associated with common geriatric syndromes.

Review on values of older adults related to the benefits and harms of preventive services (PDF File, 522 KB; PDF Help). This review addresses 1) how older adults value the potential benefits of clinical preventive services; 2) the attitudes of older adults about potential harms of clinical preventive services; 3) the value that older adults place on receiving clinical preventive services; 4) how older adults understand the balance of risks and benefits of clinical preventive services; and 5) how clinicians should engage in shared decisionmaking related to clinical preventive services in older adults.

Review on interventions to prevent functional decline in older adults (PDF File, 1.1 MB; PDF Help). This review addresses 1) multifactorial assessment and management interventions to prevent functional decline in older adults and 2) the methodological challenges in synthesizing and interpreting these findings.

Cancer screening in older adults. This review addresses the challenges of individualizing cancer screening decisions in older adults with multiple chronic conditions that may decrease additional life expectancy. A comprehensive cancer screening framework encompassing chronic illness, functional status, and health-related quality of life must consider three major challenges: 1) patient heterogeneity, 2) appropriate patient-important benefits and harms, and 3) patient preferences.

A primer for systematic reviewers on the measurement of functional status and health-related quality of life in older adults. This paper provides an overview of the methods for assessing function and health related quality of life, and evidence on the properties of prominent measures. The paper also highlights several challenges in synthesizing this evidence in older adults.

Methods of using evidence and developing recommendations on preventive services for older adults. This project addresses how to develop methods of estimating net benefit of preventive services in older adults. This may include extrapolation from data in younger age groups and adjusting for patient values, appropriate weight of benefits and harms, effects of common syndromes/comorbidities, effects of potential overdiagnosis, and effects of age and life expectancy.

USPSTF topics that focus on older adults and are currently under review include:

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USPSTF Recommendations for Older Adults

The following topics either include specific recommendations for adults ages 65 years and older or target preventive services primarily provided to older adults, diseases that carry a higher burden for older adults, or diseases that generally occur in older adults.

For a list of all USPSTF recommendations, go to http://www.uspreventiveservicestaskforce.org/uspstopics.htm.

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Opportunities to Comment on USPSTF Draft Recommendations for Older Adults

The USPSTF invites public comment on all draft recommendations before they are published. The USPSTF is taking this step as part of its ongoing effort to keep its work and methods clear to the public it serves. To read and comment on USPSTF draft recommendations for older adults, go to http://www.uspreventiveservicestaskforce.org/tfcomment.htm.

If you would like to be notified when new USPSTF draft recommendations are available for comment, please join the USPSTF Prevention E-mail List at http://www.uspreventiveservicestaskforce.org/tfsublist.htm.

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Tools for Using the USPSTF Recommendations for Older Adults

Based on recommendations from the USPSTF, these tools are designed to help primary care clinicians access information at the point of care.

Pocket Guide to Clinical Preventive Services, 2012
Electronic Preventive Services Selector (ePSS)
Partnership for Health Patient Brochures and Clinician Fact Sheets
Men: Stay Healthy at 50+
Women: Stay Healthy at 50+

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Current as of December 2013


Internet Citation:

USPSTF: Focus on Older Adults. U.S. Preventive Services Task Force. http://www.uspreventiveservicestaskforce.org/tfolderfocus.htm


 


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